HCD Headlines 3-27-2025

Rachael
Mar 27
6 min read

Starting out with this great quote from our team meeting. I just love how Vadim Zeland worded it, so I'm sharing it again. You can watch the reel again by clicking on Iron Man.

If you need to solve a problem, act. Contemplating the complexity of the problem simply creates excess potential and feeds the pendulum of your energy. When you take action, you realize the energy behind intention, and the hands do what the eyes fear to pursue.

April Schedule

Our April Schedule is up and accurate in QuickBooks Time. Doua will be out all month so we need to work as a team to stay on top of hygiene needs and the sterilization area. The front team might need to help more with perio charts which we will call out during our morning huddles.

While Edmel is out the first week of April, I will help assist in the back between DAW and DCH's teams. On the Mondays DAW is here, Jorja from Evergreen will be assisting her.

If you have any questions on the schedule, please let me know. Kudos to everyone for utilizing the portal to request time off for both paid and unpaid leave!

Updating Bios on the Webpage

We are due for updates on the website and our marketing team at Orange Slice will be helping us. Our providers will have full bios. Our clinicians and administrative teams will have 1-2 lines on what they love about dentistry and/or HCD. I will email the providers questions to make it easier to respond. Please get those back to me by April 12th.

For everyone else, please send your response to via text or email.

Update on Implant Maintenance

This article was just featured in the RDH Magazine. Short and insightful read. The highlights are:

Myth no. 1: Don’t probe around implants, but if you do, use a plastic probe
- Recent literature allows for the use of conventional metal probes if probing pressures are kept light to avoid penetrating through the perimucosal seal and damaging titanium implant surfaces.
Myth no. 2: Always use plastic scalers around implants
- ...the new guidelines from the American College of Prosthodontics state that instruments with like metals, such as titanium-on-titanium, should be used to instrument implant surfaces to avoid leaving any residue behind. Glycine powder can also be used to air polish implants.
Myth no. 3: Implants aren’t natural teeth, so they don’t require as much care
- Several systematic reviews indicate that peri-implantitis is found more frequently in patients with a history of periodontitis compared to patients without a history of periodontitis.
Myth no. 4: Implants only fail because of poor oral hygiene
- ... occlusion should be assessed regularly to ensure uniform stress distribution along the entire length of the implant. Implant-related complications can occur even in the absence of plaque, potentially leading to implant failure.

Read the whole article HERE.

Team Meeting Follow-Up

The next points are to make sure we have all this information in a central location.

Continuing Care Review

Remember to check on continuing care due dates and insurance frequency limitations. HCD has a Standard of Care regarding all continuing care, but not every insurance plan aligns with our standard. We do not allow insurance to dictate our standards, and we ensure the patient is aware of any charges that may not be covered by insurance.

Be careful when moving appointments forward in the schedule to avoid conflict with frequencies.

If the patient is due for a pano, check the frequency limitations on their insurance plan. If the provider agrees it's necessary to have the pano now, have the patient sign a treatment plan reflecting no coverage by the insurance. We will still bill insurance in hopes they will cover, but this will most likely not be the case.

Whitening Costs for Team

Clarity on whitening for our team members (TM):

$30 = Training purposes. Everyone stays clocked in. Everyone helps training the trainee.
$30 = All TM's clock out or complete treatment after hours. Cost is to cover supplies.
$100 = Opalescence Boost. TM clocks out. The administrator stays clocked in.
$11-15 (cost of syringes) = Custom trays. TM clocks out for impressions in chair. TM stays clocked in for fabrication of whitening trays if done during regular work hours. This is a low priority and shouldn't be placed above patient or team needs.

Dental Code Review

D0171 Re-Evaluation Post Op: This code specifically identifies a re-evaluation visit that occurs after a dental procedure, allowing dentists to assess the outcome and address any patient concerns.
- Do not use D7200. This is an in-house code created before ADA code was created.
- Purpose:
  - Evaluate the success of the previous treatment.
  - Address any patient concerns or discomfort.
  - Provide oral hygiene instructions and preventive care.
  - Document findings, treatment recommendations, and any additional procedures performed.
- Other Post Op codes: D7200A = 24 hour post op, D7200B = 1 week post tx

D9931-D9935 Cleaning and inspection of removable prosthetic/appliance
- D9931 – removable appliance = NG, sleep device, retainers
- D9932-9935 – denture specific for partial/complete and max/mand. These procedures are generally considered covered and have same frequency as a cleaning per benefit period.
- These codes do not have a cost associated with them UNLESS the patient brings in multiple appliances at once or if the patient is seeing us on a limited basis specifically for cleaning their appliance or denture.

D0180 Comprehensive Periodontal Evaluation: Use for new or established patient when completing a comprehensive exam with full periodontal charting. Patient must show signs or have periodontal disease and have high risk factors such as smoking or diabetes.
- Shares frequency with regular exams or limitations of D0150

D0180A – Periodontal Charting (In-house code). Must be recorded on an annual basis.
- It is a part of every RCEX.
- The PC will be reviewed by the doctor and hygienist during the exam.

SCHEDULING HYGIENE

One item we weren't able to review this Thursday was the importance of scheduling according to our agreements. This is a topic we need to revisit frequently because it's so important and we can get moving too quickly and forget the rules of the game. So let's review!

Current rules or agreements regarding hygiene:

Schedule for 30, 60, 90 minutes within templates. 30 minutes is for laser or post-op appointments. 60 minutes is for a cleaning that is with or without a periodic exam. 90 minutes is for a cleaning, periodic exam, x-rays, and periodontal charting.
- Exceptions:
  - If the patient is 0-8 years old, their RCEX and cleaning can be at 60 minutes.
  - Some patients require more time due to health concerns or communication needs. These patients should be flagged to ensure everyone is aware of the extra time needed.
Move templates as needed except for NPHYG. If a patient needs a time that doesn't match your template, move the template if possible. Do not schedule over templates as this leads to confusion and creates weird holes in the schedule.
Do not schedule exams during Monday Morning Meetings. The doctors and HCD are best served when the doctors can give all their attention to the MMM. Do not schedule any periodic exams during that time. You can, however, schedule a RCEX as that will allow them to see the patient after the meeting has completed.
Do not schedule more than 2 exams for dentist per hour. Too many exams can (and usually does) lead to frustration by all involved. Someone, somewhere is not going to receive the attention they need and deserve as our patient.
Keep exams and hygiene together to avoid too many 1 hour blocks in a row. It can be exhausting as a hygienist to have single hour blocks for every patient in the day. To avoid this drain, we have planned for multiple 90 minute appointments during the day to break up the hustle.
- Beyond breaking up the hour hustle, having the RCEX with the cleaning in the hygienist's chair allows them time for periodontal charting which is always done with x-rays.
- It also serves as a buffer for hygienists to catch up on notes or other patients' needs should they finish early. This prevents the need to stay after hours to play catch-up on the day's patients.
Schedule hygiene with exams on days their doctors are here. It should be the exception rather than the standard for separating hygiene from exams. If it is necessary, the best option is to have the exam BEFORE the hygiene appointment. This will allow hygienists to have the x-rays to help in their diagnostic and treatment needs. When this doesn't happen, the hygienist is then in a rush to complete the x-rays and perio charting in one hour.

Dental Products

Have you seen any dental products lately on Instagram or elsewhere that you thought looked interesting? New toothpaste or floss that you wanted to learn more about? Let us know and we can set up a presentation with them. A lot of times they want to get their product out there and are willing to share trial products with us. Companies like WaterPik love to present their newest gadgets to offices, too. We don't want to fill every team meeting with a sales pitch, but it's also a great opportunity for us to stay on top of the latest and greatest in dentistry and get a free breakfast... lol

Some of these we could try in-office, too. Let me know if you're interested.

You've reached the end! Send a Spring emjoi, meme or gif showing your department team you read through everything today. This will also give your department an additional chip for the lunch drawing! And remember to clock your time reading this if you're reading outside of work hours.